Carson, Mara Dawne

Carson, Mara Dawne is an individual health care provider with primary practice located at 26224 N Tatum Blvd Ste 15A , Phoenix AZ 85050-7500. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Carson, Mara Dawne can be contacted via phone (480) 663-9632.

Contact Information

Primary practice address
26224 N Tatum Blvd Ste 15A Phoenix AZ 85050-7500
Phone: (480) 663-9632
Fax: (480) 419-6782
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN259811 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN259811 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 259985 Arizona

Profile Details

NPI number 1861038044
LBN Legal business name Carson, Mara Dawne
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2019
Last updated Jan 20th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861038044 NPPES
Arizona MEDICAID 092948

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